血管内皮生长因子、妊娠相关蛋白A联合检测在鉴别诊断先兆流产及异位妊娠中的价值

摘要

Objective To study the value of combined detection of vascular endothelial growth factor(VEGF)and pregnancy associated plasma protein A(PAPP - A)in the differential diagnosis of threatened abortion and ectopic pregnancy(EP). Methods Clinical data of 327 pregnant women from July 2011 to February 2015 in The People ˊs Hospital of Mudan in Heze City were retrospectively analyzed. According to the different pregnancy methods,the women were divided into ectopic pregnancy group(n =145),threatened abortion group(n = 117)and normal pregnant group(n = 65). The expression level of serum VEGF,PAPP - A were detected by enzyme - linked immunosorbent assay,and compare the sensitivity,specificity,positive predictive value and negative predictive value of serum VEGF,PAPP - A combined detection and single detection in the diagnosis of EP. Results The expression of level of serum VEGF in threatened abortion group and ectopic pregnancy group was obviously higher than that of normal pregnancy group(P < 0. 05),while the expression level of serum PAPP - A was significantly lower than that of normal pregnancy group(P <0. 05). The expression level of serum VEGF in ectopic pregnancy group was obviously higher than that of threatened abortion group(P< 0. 05),and the expression level of serum PAPP - A was significantly lower than that in threatened abortion group(P < 0. 05). The sensitivity of serum VEGF,PAPP - A combined detection(98. 6 % )in the diagnosis of EP was significantly higher than that of serum VEGF,PAPP - A single detection(71. 4 % ,68. 7 % )(P < 0. 05). Conclusion The combined detection of serum VEGF,PAPP - A in the differential diagnosis of threatened abortion and EP has a high clinical value.%目的：探讨血管内皮生长因子（vascular endothelial growth factor，VEGF）、妊娠相关蛋白 A （pregnancy associated plasma protein A，PAPP - A）联合检测在鉴别诊断先兆流产及异位妊娠（ ectopic pregnancy，EP）中的价值。方法回顾性分析菏泽市牡丹人民医院妇产科2011年7月至2015年2月收治的327例妊娠妇女的临床资料，按照不同妊娠方式分为异位妊娠组（145例）、先兆流产组（117例）和正常妊娠组（65例）。采用酶联免疫吸附法（enzyme - linked immunosorbent assay，ELISA）检测3组血清 VEGF、PAPP -A 表达水平，并比较血清 VEGF、PAPP - A 联合及单一检测诊断 EP 的敏感性、特异性、阳性预测值及阴性预测值。结果异位妊娠组和先兆流产组患者血清 VEGF 表达水平高于正常妊娠组（P ＜0.05），PAPP - A 表达水平低于正常妊娠组（P ＜0.05）；异位妊娠组患者血清 VEGF 表达水平高于先兆流产组（P ＜0.05），PAPP - A表达水平低于先兆流产组（P ＜0.05）；血清 VEGF、PAPP - A 联合检测诊断 EP 的敏感性（98.6%）高于血清VEGF、PAPP - A 的单一检测敏感性（71.4%、68.7%）（P ＜0.05）。结论血清 VEGF、PAPP - A 联合检测在鉴别诊断先兆流产及 EP 中具有较高的临床价值。